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Background: Chronic kidney disease (CKD) is a disease that causes permanent kidney damage requiring dialysis or transplantation as a follow-up treatment. CKD is a common condition that has a high risk of coronary artery disease (CAD). In CKD patients with CAD, percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) is able to reduce mortality compared with conservative management. However, which method has the most influence on CKD patient mortality is unclear.
Objective: To find out the prognosis of mortality in post-PCI CKD patients versus CABG.
Methods: Literature search was done by using three electronic databases (Pubmed, Cochrane, and SCOPUS) using specific keywords. Keywords used were based on the authors' clinical questions. Inclusion and exclusion criteria were applied to the selected studies.
Results: A total of three literatures were selected for critical appraisal. Doulamis et al demonstrated that PCI could increase the risk of mortality in CKD patients compared to CABG (HR: 1.28, 95% CI: 1.13 - 1.46; P <0.01; I2 = 35.77%). Barbarawi et al demonstrated that there was no significant difference between mortality in patients with PCI and CABG (OR 0.90; 95% CI 0.55-1.49; P = 0.68; I2 = 54%). The study of Bundhun et al demonstrated that mortality with follow-up duration more than one year was lower in CABG (18.4%) compared to PCI (23.8%), OR 0.81, 98% CI 0.70 - 0.94; P = 0.007, I2 = 75%.
Conclusion: PCI performed in patients with CKD causes a significantly higher mortality rate than patients who underwent CABG.
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